Adverse Events in Mindfulness-Based Interventions for ADHD

Abstract

The ADHD Report • 15 Mindfulness-based interventions (MBIs) are part of a broader class of interventions referred to as “third generation” or “third wave” behavior therapies (Hayes, Follette, & Linehan, 2004; Hayes, Luoma, Bond, Masuda, & Lillis, 2006). MBIs are derived from a long-standing Eastern tradition of Vipassana meditation (Hayes et al., 2004), meaning “seeing things as they really are,” and teach mindfulness via formal meditation practice and informal practices. The term mindfulness itself is translated from the Pali word “sati” and has also been translated as “attention,” “awareness,” “retention,” and “discernment” (Davidson & Kaszniak, 2015). One widely used definition of mindfulness is that it involves adopting a nonjudgmental attention to one’s experience(s) in the present moment (Kabat-Zinn, 1990). MBIs have garnered increasing support as efficacious for a variety of mental health disorders (e.g., Kuyken et al., 2016), and in the past 10 years, researchers have extended these efforts to attention-deficit/hyperactivity disorder (ADHD). According to one recent meta-analysis (Cairncross & Miller, 2016), there is a medium effect size of MBIs on both inattentiveness and hyperactivity-impulsivity symptoms in ADHD patients. The MBI treatment literature for ADHD is relatively more developed among adult than child and adolescence samples (e.g., there are five separate trials in which an MBI was compared against a control group in adult samples and none in child or adolescent samples). However, diverse treatment effects and methodological limitations still need to be more fully addressed across children, adolescents, and adults with ADHD (e.g., Davis & Mitchell, 2018; Mitchell, Zylowska, & Kollins, 2015; Mukerji Househam & Solanto, 2016). In particular, efforts to understand the positive therapeutic effects of MBIs for ADHD need to be balanced with an understanding of adverse events. As highlighted in this and the previous issue of The ADHD Report, adverse effects of psychosocial interventions are not fully explored in many treatment studies (Berk & Parker, 2009), and this is certainly true in the MBI for ADHD literature. The aim of this article is (a) to initiate a discussion of adverse events that may be applicable to MBI for ADHD treatment studies and (b) to call for incorporation of adverse event monitoring future MBI trials with ADHD samples.